Vol. XXviii] ENTOMOLOGICAL NEtt'S. 345 



up all meats and vegetables immediately before eating them, 

 was strictly followed, with the result that the mother escaped 

 the pests and the daughter had only one light attack, would 

 seem to show that the use of exposed cold foods was respon- 

 sible for the trouble. 



The larvae are undoubtedly ingested, though it is difficult 

 to explain why this one family should continue to have trouble 

 when many other families in the same community handle food 

 in the same way without having trouble with the pest. 



The possibility of the maggots entering the stomach by be- 

 ing deposited by the fly about the mouth or nostrils seems re- 

 mote. The members of the family had not had catarrh 

 troubles or faulty teeth, which might serve to attract the parent 

 fly, and they had not practiced sleeping out of doors or other- 

 wise exposed to the fly. 



The trouble has been worse during the heat of the summer, 

 though it has, in cases, occurred early in June and as late in 

 the fall as October. The greatest trouble comes when the 

 flies would be expected to be most abundant. 



The first signs of trouble are noted a day or more previous 

 to the real attacks or the time at which medical aid is required. 

 In the base of the stomach or in the region of the transverse 

 colon a sensation similar to a rolling mass is felt. Later this 

 changes to griping which is accompanied by some fever and 

 in some cases by nausea. In case of the mother this is fol- 

 lowed by much nervousness and at times by spasms. After 

 medical assistance is given and the maggots are passed, the 

 temperature falls, though in case of severe attacks pain in the 

 bowels continues for some time and may not entirely disappear 

 until another attack comes on. The maggots may not all be 

 passed at one time and usually mature as well as immature 

 larvae are passed at the same time. 



In one case, before the family moved to Suniner, the mother 

 was placed on a grape-nuts diet for a month and throughout 

 that period trouble continued and larvae were passed. Grape- 

 nuts without milk or sugar and only boiled water were used 

 Sugar or other sweets had the effect of bringing on cramps 

 and a regular attack. This experience led the patient to the 



